| 1. |
- Buckley, Sarah, et al.
(författare)
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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum : a systematic review with implications for the function of the oxytocinergic system
- 2023
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.AIM: To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.METHODS: Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.RESULTS: Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2-3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.CONCLUSIONS: Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2-3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.
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| 2. |
- Berg, Marie, 1955, et al.
(författare)
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The use of a salutogenic framework in empirical studies of maternity care
- 2014
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Ingår i: Optimizing childbirth across Europe conference - part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care. 9-10 April 2014, Brussels.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There is general agreement that maternity care services should be organized in a way that improves health. In many European settings, this entails changing the lens of maternity care from one focused on risk and the prevention of ill-health to one stressing positive outcomes including strengths and resources. Several frameworks have been proposed for a positive health care approach within the salutogenic framework. The most wellknown, and with a strong evidence base, is Antonovsky´s Sense of Coherence Theory. Aim: To establish if and how a salutogenic theoretical approach has been used in empirical studies of maternity care. Objectives: To identify how salutogenesis has been defined in empirical research around the maternity episode, and how and in what kind of contexts salutogenic theory has been used in empirical research around the maternity episode. To generate discussion about what promotes salutogenic approaches in maternity care provision. method: A systematic literature review, based on a predetermined search strategy. no language restrictions were applied. Included studies were subject to narrative analysis. Ethical approval was not required. Findings: Eight papers met the criteria for inclusion, comprising seven areas in the antenatal, intrapartum and postnatal periods. Of these, two papers employed both a positive health philosophy and explicit use of Antonovsky's Sense of Coherence (SoC) scale. The remaining studies used discrete aspects of a salutogenic approach. Conclusion: These findings demonstrate that, to date, salutogenic framing is rarely used in maternity care research. To guide future policy making and service provision, salutogenic theory could be used to find out what works well in promoting wellbeing for those using maternity care, rather than simply minimizing ill-health and risk. Funding: The study is part of the EU-funded COST Action IS0907
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| 3. |
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| 4. |
- Magistretti, Claudia Meier, et al.
(författare)
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Best practice in maternity care: a salutogenic approach
- 2014
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Ingår i: Optimising Childbirth Across Europe An interdisciplinary maternity care conference, 9 & 10 of April, 2014 in Vrije University, Etterbeek campus, Brussels, Belgium.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The current practice to enhance and ensure quality in maternity and early infant care is mainly focused on the avoidance and management of risk. Even though studies have investigated midwives' and other professional's views, revealing several health oriented factors of quality in maternal care. most of these studies lack a theoretical framework underpinning the empirical findings and results often remain limited to the specific settings the studies were conducted in. Aim: The study "best practice in maternity care" takes a systematic theoretical approach rooted in Aaron Antonovsky's theory of salutogenesis. Although Antonovsky's concepts are widely used and empirically underpinned, they have not yet been broadly applied to maternity care and childbirth. no studies have been conducted to describe what a salutogenic midwifery practice could be. We lack evidence of questions as to how health promoting processes come about and how professionals' care can be fostered to strengthen health of mothers in maternity care. The study aims to allow maternity care professionals to express their implicit salutogenic knowledge and their action-oriented implicit frameworks for choices, decisions and conflict management and to validate and make such knowledge accessible to researchers and teachers. methods 27 narrative interviews were conducted with midwives working in pre-, peri- and postnatal care in different settings of selected regions in Austria, Switzerland and the United Kingdom. A hermeneutic analyses following the theory of Antonovsky was conducted. Ethical approval was received by all universities and health authorities concerned. findings and Conclusions: full findings will be presented showing different types of dealing with hospital and other working environments and reveal a definite spectrum of distinct Components of the three parameters of the sense of coherence (understandability, manageability, meaningfulness) in midwifery salutogenic practice. implications for training, research and practice are described in conclusion and projects in midwifery education are presented.
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| 5. |
- Magistretti, Claudia Meier, et al.
(författare)
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Setting the stage for health: Salutogenesis in midwifery professional knowledge in three European countries.
- 2016
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Ingår i: International journal of qualitative studies on health and well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of systematic evidence concerning health orientation in maternity practice in the current climate of risk avoidance. The midwifery professional project is orientated toward the preservation of normal physiological processes during the maternity episode. This study investigates accounts of midwives who were working in health-orientated birth settings, to examine if and how they frame a health orientation in professional practice. Twenty-seven narrative interviews were conducted with midwives working in pre-, peri-, and postnatal care in different maternity care settings in Switzerland, Austria, and Germany. In-depth and comparative pattern data analyses were conducted. The distinct practice orientation of the participants was revealed in three main concepts, underpinned by a common framework mirroring the three parameters of the Sense of Coherence (comprehensibility, manageability, and meaningfulness) described in Aaron Antonovsky’s salutogenic theory. The midwives’ implicit salutogenic knowledge shaped their reported actions in supporting mothers, fathers, and families to have health-promoting experiences in maternity care. These results suggest that an implicit health orientation in maternity care practice can be prefered through examination of the practice reports of midwives working in settings that have a health-promoting philosophy. Implications for midwifery practice and research are discussed. Consideration is given to the relevance of the results for debates about avoiding overtreatment and for the operationalization of salutogenic theory in health care practice.
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| 6. |
- Mittelmark, Maurice B., et al.
(författare)
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Salutogenesis for Thriving Societies
- 2022
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Ingår i: The Handbook of Salutogenesis. - Cham : Springer. - 9783030795146 - 9783030795153 ; , s. 635-638
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter is this handbook’s ‘grand finale’, addressing the potential of salutogenesis to nurture thriving societies. The handbook’s editors reflect on the advancement of salutogenesis concerning theory development, applying the salutogenic model in community settings and helping society tackle crises such as COVID-19.
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| 7. |
- Perez-Botella, Mercedes, et al.
(författare)
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The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies
- 2015
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756. ; 6:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health care outcomes used in service evaluation and research tend to measure morbidity and mortality. This is the case even in maternity care, where most women and babies are healthy. Salutogenesis theory recognises that health is a continuum, with explicit inclusion of well-being as well as illness and pathology. This offers the potential to reframe the outcomes and therefore, the focus of, maternity care research and provision. Aim: The aim of this study was to identify how salutogenesis has been defined and used in maternity care research undertaken with healthy women. Method: A scoping review was undertaken, using a formal pre-defined search strategy. Inclusion criteria encompassed research papers relating to the maternity episode up to 1 year after birth, using salutogenesis or any of its associated concepts, focused on healthy women, and written in a language which any of the members of the group could understand. The search was undertaken in two phases (database inception – April 2011 and May 2011–February 2013). Included studies were subject to narrative analysis. Findings: Eight papers met the inclusion criteria. They covered seven topics, spanning the antenatal, intrapartum and postnatal periods. Only two papers employed both positive health orientation and explicit use of Antonovsky’s theory. The remaining studies used discrete aspects of the theory. Conclusion: Salutogenic framing is rarely used in maternity care research with healthy participants. An increase in research that measures salutogenically orientated outcomes could, eventually, provide a balance to the current over-emphasis on pathology in maternity care design and provision worldwide.
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| 8. |
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| 9. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Maternal plasma levels of oxytocin during physiological childbirth : a systematic review with implications for uterine contractions and central actions of oxytocin
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.
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| 10. |
- White, Joanna, et al.
(författare)
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Stakeholder engagement and the diffusion of childbirth knowledge: Experiences of the COST project
- 2014
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Ingår i: Optimizing childbirth across Europe - an intedisciplinary maternity care conference. 9-10 April 2014, Brussels. Part of COST Action IS0907: Childbirth Cultures, Concerns & Consequences: Creating a dynamic EU framework for Optimal maternity care..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: A vital element of COST Action IS0907, "Childbirth Cultures, Concerns and Consequences: Creating a dynamic EU framework for optimal maternity care", was the engagement of servic e users and other stakeholders in the knowledge transfer associated with the Action. Strategic national seminars which took place in Sweden, Switzerland and Portugal between 2011 and 2013 and were attended by a range of local stakeholders and international COST members, prove to be an important vehicle for the sharing of experiences of childbirth cultures within and across countries as well as the dissemination of current ideas on best practice and salutogenic birth. These events involved, variously, women of reproductive age, representatives of civil society organisations concerned with pregnancy and childbirth, midwives, obstetricians, maternity unit managers, policy makers, and academics from the fields of midwifery, maternal health, sociology and anthropology. This presentation will give a multi-media flavour of the proceedings of the seminars, including the debates which occurred around "optimal" birth. A broader aim is to highlight how intra- and inter-country exchange on childbirth through public events can be catalysed by initiatives such as the COST Action. Medium: A cross-over between an artistic presentation and an informative poster, including text, photography, video and sound. Description of content: A poster-style stand will provide a visual entrypoint, presenting textual and photographic extracts of the events and their outcomes. digital sound recording will share elements of the debates which took place. Selected video presentations from the seminars related to normal birth will be shared on a loop. The audience will be invited to provide their feedback either in writing or video; these responses will become part of the presentation. This presentation can be made during break periods when the organisers of the seminars will be available to answer questions and interact with the audience.
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